Applying Do No Harm Principles To Healthcare Costs

Do no harm. This simple medical precept lies at the foundation of medical ethics. But what constitutes harm? A new report by the Washington Health Alliance (WHA) pushes the envelope of do no harm principles beyond the physical to include financial harm.

“In this day and age, when the cost of health care and the advent of high deductible health plans represent a growing financial risk to individuals, 'harm' takes on a broader meaning.” — Excerpt from First, Do No Harm: Calculating Health Care Waste in Washington State

Financial harm results from medical waste spending

According to the WHA, one of the most significant sources of financial harm comes from wasted spending on healthcare services. Wasted spending is defined by tests or procedures that aren’t entirely necessary or supported by evidence. For example, ordering an MRI when an Xray would provide results that are sufficient for an accurate diagnosis and treatment plan.

The report identifies 47 common treatment approaches that are recognized by the broader medical community to be frequently overused. To identify whether a treatment approach represented a waste in medical spending, the WHA analyzed use cases to determine when those frequently overused treatments had been:

Supported by evidence;

Truly necessary;

Not duplicative of other tests or procedures already received; and

As free from harm as possible

In their analysis of claims data for more than 2.4 million individuals, the WHA found that 47.9% of individuals had received low-value services, representing $282 million in unnecessary healthcare services costs.

Vera protect patients from financial harm

So, what’s the solution? Included in the report are key initiatives to help solve the problem of overuse. Among them is a call for clinical leaders to incorporate reduction of overuse into daily practices. Here’s how Vera does it.

Little-to-no cost primary care services

Vera eliminates overused treatment approaches as a cause of financial harm by providing all primary care to patients at no charge.

At the core of Vera’s model is an on-site clinic where employees can go for all of their primary care needs. Those primary care services are provided at little-to-no cost. Because many of the most common treatment measures identified by the WHA report as overused are available in a primary care environment, they aren’t capable of causing financial harm to patients.

Highly coordinated referral management

Vera protects patients from financial harm by reducing unnecessary referrals. Vera’s managed care approach means that patients enjoy the benefits of highly coordinated referral management. We curate referrals so that patients get the right care they need when they need it. If specialty care is required, we work with the patient to determine the best fit for their needs, balancing high value and low cost.

Empathetic listening model

Vera defends against emotional and financial harm through empathetic listening approaches that empower patients to take ownership of their own health.

Unlike traditional healthcare systems where providers have an average of 7 minutes with patients, Vera providers give the time and attention needed by patients. Average Vera appointments are around 30 minutes, and an Annual Whole Health Evaluation includes a 60-minute appointment with a primary care provider. That time allows patients and providers the opportunity to form meaningful connections and make informed decisions about a personalized care plan.

According to the WHA, this shared decision-making approach is fundamental to managing spending.

“Patients need objective information, based on evidence and well-vetted clinical guidelines, to help them understand treatment choices and their risks and benefits ... Patients need the opportunity to express their preference(s) and to have them respected." — Excerpt from First, Do No Harm: Calculating Health Care Waste in Washington State

When patients are given the time to objectively understand the risks and rewards of possible treatment plans, they’re empowered to take ownership of their health.

Built-in protection from all types of harm

For Vera, the precept of do no harm is a directive that guides every aspect of our care. We eliminate financial harm by providing patients with primary care services at little-to-no cost. We eliminate emotional harm through our empathetic listening practices that provide patients and providers with the time and resources they need to form meaningful connections. We eliminate physical harm by treating a patient’s whole health and coaching them toward better health outcomes.